[¹⁸F-FDG PET-CT最大标准摄取值及T/N比值与结直肠癌术后预后的相关性]
[Correlation of ¹⁸F-FDG PET-CT maximum standard uptake value and T/N ratio with the prognosis of postoperative colorectal cancer].
作者信息
Wang Xiaoyan, Peng Guijuan, Zhang Xiangsong, Chen Zhifeng, Zhang Bing, Li Ziping
机构信息
Department of Nuclear Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
出版信息
Zhonghua Wei Chang Wai Ke Za Zhi. 2015 Mar;18(3):232-7.
OBJECTIVE
To assess the correlation of primary colorectal cancer (CRC) lesions' maximum standardized uptake value (SUVmax) and tumor to normal tissue SUVmax ratio (T/N ratio) detected by ¹⁸F-deoxyglucose positron emission computed tomography (¹⁸F-FDG PET-CT) imaging with the postoperative prognosis.
METHODS
Clinicopathological data of 92 CRC patients who underwent curative resection after the PET-CT examination and received ¹⁸F-FDG PET-CT examination from January 2009 to December 2013 in the First Affiliated Hospital of Sun Yat-sen University were reviewed retrospectively. The correlation of SUVmax and T/N ratio in primary lesions with clinicopathological factors was analyzed. The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were investigated by using ROC curve analysis. Association of clinicopathological factors and prognosis was examined and the Cox proportional hazard regression model was used in the multivariate analysis.
RESULTS
Primary SUVmax was associated with tumor TNM staging, location, differentiation degree and the maximum tumor diameter, while T/N ratio was only associated with pathological type (all P<0.05). The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were 12.2 (sensitivity 67.6%, specificity 63.6% ), 6.9 (sensitivity 51.4%, specificity 74.5%) and 4.3 cm (sensitivity 56.8%, specificity 80.0%) respectively. Univariate analysis showed that age, TNM staging, tumor location, differentiation degree, the maximum tumor diameter, T/N ratio and CA125 level were significant predictors of survival. Multivariate analysis demonstrated that TNM staging (P=0.000, OR=3.98, 95% CI:2.12-7.45), tumor location (P=0.009, OR=0.43, 95% CI:0.23-0.81), tumor differentiation degree (P=0.001, OR=7.52, 95% CI:2.12-25.9) and T/N ratio (P=0.008, OR=2.92, 95% CI:1.33-6.411) were independent predictors of survival. However, SUVmax was not independent predictor of disease-free survival.
CONCLUSION
For postoperative prognosis of colorectal cancer patients, T/N ratio is more valuable than the of primary tumor SUVmax.
目的
评估¹⁸F - 脱氧葡萄糖正电子发射计算机断层显像（¹⁸F - FDG PET - CT）检测的原发性结直肠癌（CRC）病灶的最大标准化摄取值（SUVmax）及肿瘤与正常组织SUVmax比值（T/N比值）与术后预后的相关性。
方法
回顾性分析2009年1月至2013年12月在中山大学附属第一医院接受PET - CT检查并行根治性切除的92例CRC患者的临床病理资料。分析原发灶SUVmax和T/N比值与临床病理因素的相关性。采用ROC曲线分析探讨SUVmax、T/N比值及最大肿瘤直径无病生存时间的最佳截断点。检验临床病理因素与预后的相关性，并在多因素分析中使用Cox比例风险回归模型。
结果
原发灶SUVmax与肿瘤TNM分期、位置、分化程度及最大肿瘤直径相关，而T/N比值仅与病理类型相关（均P<0.05）。SUVmax、T/N比值及最大肿瘤直径无病生存时间的最佳截断点分别为12.2（敏感度67.6%，特异度63.6%）、6.9（敏感度51.4%，特异度74.5%）及4.3 cm（敏感度56.8%，特异度80.0%）。单因素分析显示年龄、TNM分期、肿瘤位置、分化程度、最大肿瘤直径、T/N比值及CA125水平是生存的重要预测因素。多因素分析表明TNM分期（P = 0.000，OR = 3.98，95%CI：2.12 - 7.45）、肿瘤位置（P = 0.009，OR = 0.43，95%CI：0.23 - 0.81）、肿瘤分化程度（P = 0.001，OR = 7.52，95%CI：2.12 - 25.9）及T/N比值（P = 0.008，OR = 2.92，95%CI：1.33 - 6.411）是生存的独立预测因素。然而，SUVmax不是无病生存的独立预测因素。
结论
对于结直肠癌患者的术后预后，T/N比值比原发肿瘤SUVmax更有价值。
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